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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sjgov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> QUIK STOP MARKET #, 2285 E FREMONT ST STOCKFON A rli 10, 2015 <br /> your hazardous materia tivity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJ T TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received By(printed name and title): Date.- <br /> (signature): <br /> ate:(signature): Denise Hood, Cashier <br /> Inspector _ Inspector(printed name and title): Inspector Phone: <br /> (signature): G 3 HAZA SAEED, HM Specialist 1 (209) 953-6212 <br /> Page 2 of 2 <br />